HB Outpatient Coding Educator/Auditor - Remote

Overview Your job is more than a job The Coding Educator Auditor will coordinate coding audits and education functions of LCMC system coding services. This individual will be responsible for managing and working the edit and denial coding work queues for inpatient, outpatient and ambulatory settings and will provide coding feedback for education opportunities identified to the coding team. Prepares and presents educational programs related to coding. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, understand current professional coder workflows, and review principal, secondary diagnoses and procedures for hospital and physician (professional) services for inpatient and outpatient records based on knowledge of coding systems, including ICD-10 and CPT. Responsibilities Reviews cases for accurate coding, monitoring the assignment and sequencing of ICD-10-CM/PCS and CPT codes to facilitate the correct assignment of diagnostic and procedure codes. Sequences diagnoses and procedures accurately according to coding principles. Reviews non-CC/MCC records to determine if the record was miscoded or if additional documentation is needed. Works coding edits work queues and provides feedback and coding education to coding staff regarding completeness and accuracy of code assignment. Utilizes retrospective edit tool to address possible coding and/or documentation issues related to submitted diagnosis and procedure information obtained from the health record. Reviews discrepancies between Clinical Documentation Specialist (CDS) DRG and the Coder DRG. Performs reviews in a timely manner to maintain DNFB within the assigned targeted goals. Assist in the development and provides ICD-10-CM/PCS, CPT/HCPCS, DRG (MS & APR) and APC auditing, coding and reimbursement training. Monitor and report the coder's progress through the orientation and training processes. Establish timelines for training completion specific to the level of training necessary. Keeps abreast of new regulatory requirements, annual revisions to the codes, etc., and applies this information appropriately. Works as subject matter expert and provides expertise when applicable. Performs and reports research on topics related to health information management, coding, billing and related compliance issues. Ensures audit findings and trends are investigated and education is prepared and reviewed with coding staff when necessary. Monitors changes in laws, regulations, standards as they affect coding, billing and related compliance. Reads, analyzes and interprets laws, regulations, policies and procedures governing the healthcare revenue cycle. Identifies potential areas of compliance vulnerability and risk, develops potential corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future. Prepares and distributes audit results/reports for the system coding program to Coding management staff. Works with coding Manager to improve coding services provided by coding staff. Assist system coding leadership with training and/or development of a performance improvement track for coding staff in the disciplinary process related to quality or productivity performance. Performs special coding-related projects as assigned. Other duties as assigned. Qualifications Experience: 5 years in physician and hospital coding, 2 years of coding audit (LCMC). Preferred: experience in Cardiology on PB or HB side. Education Required: Associate's Degree in Health Information Management (LCMC). Licenses and Certifications Certified Inpatient Coder (CIC) — Required; Issuer: American Academy of Professional Coders (AAPC); Entity: LCMC. Certified Professional Coder (CPC) — Required; Issuer: AAPC; Entity: LCMC. Certified Coding Specialist (CCS) — Required; Issuer: CCHIIM; Entity: LCMC. Registered Health Information Technician (RHIT) — Issuer: CCHIIM/AHIMA; Entity: LCMC. Registered Health Information Administrator (RHIA) — Issuer: CCHIIM/AHIMA; Entity: LCMC. Skills and Abilities Knowledge of electronic health records, health information systems and healthcare applications and their effects on coding practices. High ethical standards. Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRG, APR-DRG and APC coding principles and guidelines. Experience in ICD-10-CM/PCS auditing, coding and reimbursement training. Knowledge of Prospective Payment System (PPS) methodology for inpatient, outpatient, ambulatory and provider-based clinic encounters. Extensive knowledge of hospital and professional coding including provider-based billing. Knowledge of documentation regulations of Joint Commission and CMS. Experience with concurrent coding reviews. Knowledge of medical terminology, classifications systems and vocabularies. Knowledge of privacy and security regulations, confidentiality, laws, and release of information practices. Experience in assisting and identifying learning needs and providing education and training to support a learning organization. Strong analytical and problem-solving skills. Excellent oral, written and interpersonal communication skills. Ability to organize and set priorities to meet objectives in a timely manner. Ability to adapt to change and handle challenges proactively and with poise. Ability to collaborate effectively with physicians and managerial staff at all levels. Work Shift Days (United States of America) About LCMC Health LCMC Health is a community. Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary. Additional Information Your extras: Deliver healthcare with heart; Give people a reason to smile; Put a little love in your work; Be honest and real, but with compassion; Bring some lagniappe into everything you do; Forget one-size-fits-all, think one-of-a-kind care; See opportunities, not problems – it’s all about perspective; Cheerlead ideas, differences, and each other; Love what makes you, you - because we do. Equal Opportunity You are welcome here. LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary. Application Notes To get started, complete the application accurately. Incomplete applications may be eliminated due to missing information. To ensure quality care and service, we may verify information on your application with previous employment and background checks. Applications are inactive after 6 months and require a new application for employment to be completed. Proof of citizenship or immigration status may be required to verify your lawful right to work in the United States. #J-18808-Ljbffr LCMC Health